Positive mental health and sense of coherence among emergency medical service professionals.

Background: Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. Objective: This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. Methods: A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. Results: High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Conclusion: Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

Fotovoz de activos en Cornellà de Llobregat, una experiencia de los profesionales sanitarios para conocer la comunidad / Photovoice of Cornellà de Llobregat assets, an experience for healthcare professionals to get to know the community

Introducción. La prescripción social es el proceso de recomendación de activos beneficiosos para la salud y bienestar. Para ello es necesario conocer los activos de la comunidad de trabajo. El fotovoz es una técnica de investigación participativa que permite conocer una comunidad con la fotografía.Objetivos. Elaborar un fotovoz con los activos de salud de la comunidad.Métodos. Se formó a profesionales y se hizo un paseo comunitario para identificar y fotografiar activos de la comunidad. Se hizo una puesta en común de las fotografías recogidas y una selección. Se creó un fotovoz que se expuso en el centro.Resultados. Un total de 17 profesionales sanitarios hicieron 91 fotografías a activos. Se hizo una selección y se llevó a cabo una discusión, y como resultado, se creó un fotovoz con 16 activos.Conclusión. El fotovoz es un proceso participativo basado en la comunidad que permite mejorar el conocimiento que los profesionales sanitarios tienen sobre los recursos de salud disponibles en su entorno y hacer una prescripción social. (AU)

Introduction. Social prescribing is the process of recommending assets beneficial to health and well-being. To do this, it is necessary to get to know the assets of the working community. Photovoice is a participatory research technique that enables getting to know a community with photography.Objectives. Prepare a Photovoice with community health assets.Methods. Professionals were trained and a community walk was held to identify and photograph community assets. A sharing the photographs collected and made a selection. A Photovoice was created and exhibited in the centre.Results. A total of 17 healthcare professionals took 91 asset photographs. A selection was made and a discussion held. As a result a photovoice was created with 16 assets.Conclusion. PhotoVoice is a community-based participatory process that enables improving health professionals' knowledge of the health resources available in their setting and enables social prescribing. (AU)

The Mediating Role of Sense of Coherence and Striving for Work-Life Balance on Intention to Leave From Nurses' Burnout.

High turnover and understaffing are significant issues plaguing the healthcare system. Some of the leading reasons of turnover include child-bearing and -rearing, stress related to working, and health concerns. With the onset of the coronavirus (COVID-19) pandemic, this problem of turnover worsened due to increased risk of infection and escalating workload. This study aimed to clarify and validate the effect of burnout on intention to leave among full-time nursing professionals and the structural relationship with sense of coherence (SOC) and striving for work-life balance (S-WLB). Secondary analyses of data obtained from a previous study was carried out; a hypothesized model was tested for goodness of fit and a final model was developed. Burnout directly affected intention to leave (P < .001). It also affected intention to leave through SOC and S-WLB (P < .01); SOC lessened the effect of burnout on S-WLB, therefore reducing its impact on intention to leave. Effective strategies need to be developed to improve the SOC and WLB of nurses to alleviate the effects of burnout and thus reduce the likelihood of turnover. Improving their ability to grasp and deal with emergencies and ambiguous situations, as well as providing emotional and tangible support can be other ways to retain nursing professionals.

Self-Care and Sense of Coherence: A Salutogenic Model for Health and Care in Nursing Education.

BACKGROUND: Effective advocacy on self-care and the enhancement of a sense of coherence among nurses don't only benefit control over one's health and personal performance, but it may have a direct impact on clinical care and on the entire healing system. In this regard, nursing curricula grounded on a salutogenic model of health (SMH) operate with strategies to engage students in self-care and contribute to improving their mental health and wellbeing. The aim of this study was to explore the relationships between self-care agency and a sense of coherence as dependent variables and the age and self-reported academic performance as independent variables in nursing assistant students. METHODS: For this cross-sectional study, data were collected from a full sample of 921 Certified Nursing Assistant (CNA) Spanish students. A self-administered questionnaire, including sociodemographic variables, the 'appraisal of self-care agency' (ASA), and the 'sense of coherence' (SOC) constructs, was administered. RESULTS: Older participants presented significantly stronger values of both constructs. Apart from a significant and positive correlation between ASAS and SOC, ANOVA analyses indicate significant differences in terms of academic performance according to different ASAS and SOC degrees. CONCLUSIONS: The findings of this study endorse the assumption that there is a consistent relationship between ASA and SOC constructs that might, indeed, have a potential effect on students' academic performance. In practical terms, it seems relevant to try to recognise the students' self-care agency and the sense of coherence as forceful predictive variables of mental health and wellbeing, in addition to academic success as a strength implied in the future career achievement.

Salutogenic Model-Based Frailty Prevention Program for Pre-Frail Women Aged 55 Years and Over (SAFRAPP): A Study Protocol for a Randomized Controlled Trial.

Background: Frailty is a geriatric syndrome which is more higher among women. Limited evidence suggests a model-based intervention for preventing worsening frailty for women. Purpose: This protocol describes a single-blinded, two-armed randomized controlled study purposing to examine the effectiveness of Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) for pre-frail women. Methods: Eighty-four eligible participants from vocational institutions of a municipality in Turkey is randomly allocated to either the SAFRAPP intervention or the control group. The SAFRAPP is a 6-week online nurse-led intervention program comprising of laughter yoga, health education and case management. The intervention is rooted in the Salutogenic Model, which focuses on strengthening individuals' coping capacity to deal with stressors. The primary outcomes are the frailty and sence of coherence scores and the secondary outcomes are the well-being, quality of life and fear of fall scores, and number of falls and emergency admissions in the past three months. The study data for intervention and control group is obtained at four times: At baseline and at the 3-month, 6-month and 9-month follow-ups. Results: The protocol was registered at ClinicalTrials.gov (identifier number NCT04787432, registration date: 08/03/2021). Eligibility, baseline measurements, randomization, and intervention are completed. The follow-ups are ongoing. Implications for Practice: There is unsufficient evidence regarding the effectiveness of a model-based health promotion interventions for prevention of frailty. The SAFRAPP will provide evidence on prevention of frailty and improving sense of coherence of pre-frail women.

Testing the Effectiveness of a Salutogenic Model for Reducing Suicidal Tendencies in a Population of Elderly and Young Adults.

Suicide is a leading cause of mortality worldwide, with the elderly having the highest suicide rates. This study tests the effectiveness of a salutogenic model in normative elderly people compared with young adults in protecting against risk behaviors and suicidal tendencies, based on two variables: locus of control and meaning in life (mediating variable between locus of control and suicidal tendency). Participants were 191 people aged 65 to 100 years and 200 young adults aged 18 to 28 years old. Participants completed questionnaires on locus of control and purpose in life and were assessed for suicidal tendencies. Findings reveal a negative effect of age on locus of control, purpose in life, and a negative correlation between purpose in life and internal locus of control and suicidal tendency. Purpose in life mediates between internal locus of control and suicidal tendency in both populations. The salutogenic model has significant implications and can be used to reduce suicidal tendencies.

Family Sense of Coherence Scale: A Confirmatory Factor Analysis in a Portuguese Sample.

Background: Family sense of coherence (FSOC) can be defined as the cognitive map of a family that enables the family to deal with stress during their lifetime. FSOC is the degree to which a family perceives family life as comprehensible, manageable, and meaningful. To the best of our knowledge, few studies have used this scale, and very few have evaluated FSOC Scale psychometric properties. Objective: This study aimed to evaluate the psychometric properties of the original FSOC Scale in a sample of Portuguese caregivers of children aged between 10 and 15 years. Methods: A total of 329 caregivers completed a sociodemographic questionnaire and the FSOC Scale. Analyses were performed to evaluate the factor structure of the FSOC Scale with 26 items as well as composite reliability, internal consistency, convergent-related validity, and discriminant-related validity of the scale scores. Results: The findings supported a three-factor solution for a 13-item version that maintains the original FSOC Scale structure. The three FSOC dimensions presented a good fit to the data. Cronbach's alpha, composite reliability, and convergent-related validity were considered very good for the FSOC Scale (α = 0.956; CR = 0.974; AVE = 0.689). No evidence of discriminant-related validity was found for the dimensions of FSOC. Conclusion: The findings support the use of the Portuguese FSOC Scale for research and clinical purposes with Portuguese caregivers. Future research is necessary to further develop a European Portuguese version of the FSOC Scale. Implications: This study provides a psychometric evaluation of FSOC Scale characteristics in a Portuguese sample. The results are helpful for clinicians and family therapists who work with families since it could help them to assess the resources of families and their ability to cope with adversity and enhance their strengths.

Health Assets, Vocation and Zest for Healthcare work. A Salutogenic Approach to Active Coping among Certified Nursing Assistant Students.

People's health assets (HA) mapping process and design dynamization strategies for it are paramount issues for health promotion. These strategies improve the health heritage of individuals and communities as both the salutogenic model of health (SMH) and health assets model (HAM) defend. Connecting and mobilizing HA and strengthens the 'sense of coherence' (SOC) are both related to enhancing stress active and effective coping strategies. This study aims to describe the HA present in a population of certified nursing assistant students (n = 921) in Spain and then to explore their relationships with the SOC, the motivation to choose healthcare studies and their academic performance. A great variety of HA were identified and mapped. Findings showed that individuals with greater motivation towards self-care and 'caring for others' as internal HA, possessed higher SOC levels and a strong vocation for healthcare work. Differences in HA were identified according to gender, age and employment situation. Consistent connections between the care-relation factor and vocational factor with interpersonal and extrapersonal HA were reported. Evidence and results substantiated the salutogenic and asset-based approach as a proper strategy to strengthen SOC, dynamize their HA map, reinforce the sense of calling and enable Certified Nurse Assistant (CNA) students to buffer against caregiving-related stress and thrive in their profession.

Sense of coherence, academic performance and professional vocation in Certified Nursing Assistant students.

BACKGROUND: The sense of coherence (SOC) of the salutogenic health model explains why people in stressful situations are able to maintain or even improve their health. There are some studies on which measures are more effective to reduce stress in Nursing assistant students. There are no studies that link SOC with the two key aspects in the prevention of stress in Nursing assistant students: the motivation of pursuing this profession and the academic level. OBJECTIVES: To explore the salutogenic paradigm among Nursing assistant students in a region of Spain (Comunitat Valenciana). DESIGN: Cross-sectional, analytical and exploratory study carried out in 2016. METHODS: Students of the first year of Nursing Assistant certification. Self-administered questionnaire to collect the variables: Sense of Coherence (SOC-13 instrument); professional vocation; Self-reported grades of the academic record. RESULTS: The mean score for the total SOC measurement was M = 56.38 (SD = 12.236; 71). Regarding the SOC components, the average score was for Manageability M = 16.45 (SD = 4.53; 24); Comprehensibility M = 19.27 (SD = 5.642; 30) and Meaningfulness M = 20.65 (SD = 4.48; 23). Students who lived in rural environments presented a weaker SOC (M = 54.05), compared to those who were located in urban environments (M = 56.83) and large cities (M = 56.15). The students who reported a choice of studies motivated by professional vocation presented a stronger SOC, scoring also a remarkable academic performance (p < 0.05). CONCLUSIONS: Strong levels of SOC in Nursing assistant students, are related to a greater motivation to study something desirable, and to obtaining high academic performance, despite being a demanding and high-stress profession. Therefore, a strong SOC seems to contribute to being more resistant to stress. The environments that provide and facilitate greater external resources such as health, education, culture, association, leisure and recreation, for the community, have higher global levels of sense of coherence.

The relation between sense of coherence and daily hassles among university students.

Based on Antonovsky's salutogenic model, it was hypothesized that persons with a high sense of coherence (SOC), compared to persons with a low SOC, (1) experience fewer hassles and (2) experience hassles as less stressful. In addition to each of the two main hypotheses, gender differences and interaction between SOC and gender were also explored. Two hundred and fifty-eight female students (Mage = 23.77 years) and 136 male students (Mage = 24.02 years) participated in a survey where they responded to a questionnaire that was designed to measure some demographic variables, SOC and daily hassles. The data were analysed by two 3 (SOC-groups) × 2 (Gender) ANOVAs for independent measures, with frequency and intensity as dependent variables, followed up with Tukey's HSD post-hoc tests. The results confirmed both main hypotheses. In addition, the results showed no interaction between SOC and gender, no differences between female and male students with regard to the number of experienced hassles but that female students experienced the hassles more intensively. These findings further corroborated the two fundamental parts of Antonovsky's salutogenic model concerned with avoidance and appraisal of stressors.

Challenges and coping strategies of orphaned children in Tanzania who are not adequately cared for by adults.

Orphaned children in poor rural communities sometimes have no adult who is able to care for them or else the adult caregiver is not able to provide adequate care. Tanzania remains one of the poorest countries in the world, and poverty frequently constrains foster care. Although HIV prevalence is declining, AIDS is still a major cause of orphaning. This article explores the challenges and coping strategies accompanying two possible life trajectories for orphaned children without adequate adult care: 1) that they remain in rural areas in child-headed households, or 2) that they are trafficked to an urban area. Antonovsky's salutogenic model is used as the theoretical framework. The data come from two separate phenomenological studies with vulnerable children. In the first study, in-depth interviews were held with 12 orphaned children in a poor rural area; data concerning three child heads of households are included here. In the second study, 15 girls who were trafficked from rural areas to Dar es Salaam gave extended life-history narrations; data are included for nine of the girls who were orphaned. Loss of parents, a lack of cash, and the need to balance school attendance with food production were chronic stressors for the children heading households, while resources included income-generation strategies and the ability to negotiate with teachers for time to cultivate. For the trafficked girls chronic stressors included exploitation, long working hours, little or no pay, isolation and rape. Resources for them, although limited, included faith networks and neighbours; escape from the exploitative situation frequently involved external help. We conclude that given physical and social assets the child-headed households were able to cope with the challenges of caring for themselves and a younger child, but isolation and dependency on employers made it difficult for the trafficked girls to cope with this exploitation. The salutogenic model proved a useful tool in analysing the coping strategies of children living without adequate adult care.